title: Clinical implication of serum C-reactive protein in patients with uncomplicated acute pyelonephritis as marker of prolonged hospitalization and recurrence.
abstract: OBJECTIVE
  To analyze the clinical value of C-reactive protein (CRP) as a marker of prolonged hospitalization and a predictor of recurrence in patients after uncomplicated acute pyelonephritis (APN).
  
  
  METHODS
  A total of 202 consecutive adult patients with APN were prospectively enrolled from September 2005 to June 2007. APN was defined as the concomitant presence of 4 major and >/=2 minor clinical or laboratory signs or symptoms suggestive of APN. All patients were treated with parenteral antibiotics. The patients were discharged after normalization of body temperature, serum white blood cell counts, and urinalysis. Correlations among the recurrence of APN and various factors, including CRP, were investigated.
  
  
  RESULTS
  Of the 202 patients, 13 were excluded because of the presence of complicating factors or insufficient data. APN recurrence developed in 4 patients (2.1%). The CRP level at discharge correlated significantly with the recurrence of APN on univariate and multivariate analysis. Irrespective of the normalization of body temperature, serum white blood cell counts, and urinalysis, the recurrence of APN was significantly greater in the patients with CRP >4 mg/dL than in those with <4 mg/dL at discharge. Patients with a maximal CRP of >15 mg/dL during admission had a longer hospitalization and required more intravenous antibiotic therapy than did the patients with a maximal CRP of <15 mg/dL.
  
  
  CONCLUSIONS
  As a marker of prolonged hospitalization and recurrence, CRP can complement the present clinical and laboratory parameters used as guides in the proper treatment of patients with uncomplicated APN.
authors.affiliation: Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Yang
authors.forename: In Rae
authors.initials: IR
authors.lastname: Cho
authors.forename: Do Hwan
authors.initials: do H
authors.lastname: Seong
authors.forename: Yun Seob
authors.initials: YS
authors.lastname: Song
authors.forename: Dong Hyeon
authors.initials: DH
authors.lastname: Lee
authors.forename: Ki Hak
authors.initials: KH
authors.lastname: Song
authors.forename: Kang Su
authors.initials: KS
authors.lastname: Cho
authors.forename: Woo
authors.initials: W
authors.lastname: Sung Hong
authors.forename: Hong Sup
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011704:Pyelonephritis / Q000097:blood*; D012008:Recurrence; D013997:Time Factors; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein